Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.46 / $33.64 / $56.85	Facility	26	$29.46	$33.64	$56.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.87 / $125.23 / $605.46	Professional		$85.87	$125.23	$605.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.82 / $44.60 / $137.94	Professional	26	$26.82	$44.60	$137.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.70 / $84.53 / $186.04	Professional	TC	$58.70	$84.53	$186.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.18 / $74.41 / $103.35	Professional		$71.18	$74.41	$103.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $30.69 / $47.75	Professional	26	$22.43	$30.69	$47.75
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.42 / $54.42 / $58.15	Professional	TC	$54.42	$54.42	$58.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.13 / $116.91 / $208.38	Professional		$91.13	$116.91	$208.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $38.95 / $62.84	Professional	26	$31.65	$38.95	$62.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.15 / $78.00 / $148.84	Professional	TC	$58.15	$78.00	$148.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.11 / $119.16 / $221.58	Professional		$72.11	$119.16	$221.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $39.47 / $74.23	Professional	26	$25.57	$39.47	$74.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.28 / $80.77 / $154.61	Professional	TC	$45.28	$80.77	$154.61
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $71.41 / $136.22 / $136.22	Facility	26	$71.41	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $129.65 / $654.87	Professional		$90.81	$129.65	$654.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.57 / $39.72 / $217.94	Professional	26	$30.57	$39.72	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $61.39 / $94.35 / $461.63	Professional	TC	$61.39	$94.35	$461.63
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $54.91 / $54.91	Professional	26	$54.91	$54.91	$54.91
United Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $114.71 / $191.54	Professional		$84.41	$114.71	$191.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $35.47 / $66.17	Professional	26	$28.94	$35.47	$66.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.73 / $81.78 / $132.82	Professional	TC	$55.73	$81.78	$132.82